静脉滴注七叶皂苷钠致听力下降

1例56岁男性患者因病毒性脑膜炎给予阿昔洛韦0.5 g溶于250 ml生理盐水,3次/d静脉滴注及甘露醇125ml,4次/d静脉滴注治疗.第5天加用七叶皂苷钠20 mg溶于250 ml生理盐水,1次/d静脉滴注,滴速60滴/min,约60 min输注完毕.输注完毕约8 h后,患者出现耳部闷胀不适、耳鸣及对声音分辨能力下降.次日耳部不适感和耳鸣消失,声音分辨能力下降无明显改善.纯音电测听检查示双耳高频听力中度受损,感音神经性听力减退.4 d后再次应用七叶皂苷钠,剂量及用法同前,约10 h后再次出现听力下降、耳部不适、耳鸣.次日耳部不适感及耳鸣均消失,但声音分辨能力下降无明显缓解.给予维生素C、复合维生素B,约2个月后患者听力明显恢复.

Hypoacusis after an intravenous infusion of sodium aescinate

A 56-year-old man received an IV infusion of acyclovir 0.5 g diluted in normal saline solution 250 ml three times daily and an IV infusion of mannitol 125 ml four times daily for viral meningitis.On day 5,an IV infusion of sodium aescinate 20 mg in saline solution 250 ml once daily at a rate of 60 drops/min within 60 minutes was added to the regimen.About 8 hours after infusion completion,the patient developed discomfort and a sensation of fullness in the ear,tinnitus,and decreased sound resolution.The next day,His ear discomfort and tinnitus subsided,but decreased sound resolution did not markedly improve.Pure tone audiometry showed moderate high frequency hearing loss in both ears and sensorineural hearing loss.Four days later,sodium aescinate was given again and the dosage and administration were the same as before.Ten hours later,hypoacusis,ear discomfort,and tinnitus recurred and,the next day,ear discomfort and tinnitus disappeared,whereas decreased sound resolution did not markedly improve.Vitamin C and vitamin B complex were given and,about two months later,his hearing apparently recovered.